Healthcare Provider Details

I. General information

NPI: 1992388383
Provider Name (Legal Business Name): NATALIE REIDY CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2021
Last Update Date: 05/16/2022
Certification Date: 05/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 HILL RD N
PICKERINGTON OH
43147-8986
US

IV. Provider business mailing address

1300 HILL RD N
PICKERINGTON OH
43147-8986
US

V. Phone/Fax

Practice location:
  • Phone: 248-660-1220
  • Fax:
Mailing address:
  • Phone: 248-660-1220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0028835
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAPRN.CNP.0028835
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: